Removing the interference of daratumumab on transfusion compatibility testing and transfusion efficacy comparison
Journal Title: Chinese Journal of Blood Transfusion - Year 2024, Vol 37, Issue 2
Abstract
Objective To explore the feasibility of blood transfusion compatibility testing for multiple myeloma(MM) patients treated with anti-CD38 monoclonal antibody daratumumab (DARA) after DARA-Fab fragment blocking, and to evaluate the transfusion efficacy by comparing with dithiothreitol(DTT) method. Methods After DARA was prepared into DARA-Fab fragments using PierceFab preparation kit, the neutralization effects of different volumes (5, 10, 15, 30 μL) on screening cells and panel cells were confirmed. DARA-Fab fragments and screening cells with specific antigens and corresponding monoclonal antibody reagents were used as the experimental group and the control group with the same volume of saline for incubating and centrifugin.Twenty MM patients treated with DARA were selected for cross-matching with DARA-Fab and DTT respectively, and the laboratory indexes before and after transfusion were statistically analyzed, and the two blood matching methods were compared. Results After incubating and centrifuging, the results of DARA-Fab fragments(15, 30 μL) with screening cells and serum mixed with DARA were negative, while those of DARA-Fab(5, 10 μL) were positive. 15μL DARA-Fab treated antibody identification cells (2, 3, 4, 5, 7, 9, 11) were negative, antibody identification cells (1, 6, 8, 10, 12) were negative after 30 μL DARA-Fab fragments treatment; the results of MNS, Duffy, Kidd, Kell, Lewis, Rh blood group system of the experimental group were consistent with those of the control group; the hemoglobin (Hb) (g/L) of 20 patients after infusion of RBC (73.90±1.90) was significantly higher than that before transfusion (63.60±1.58), P<0.01. There was no significant difference in total bilirubin(TBil)(μmol/L)(16.25±3.54 vs 17.87±3.57), direct bilirubin(DBIL)(μmol/L)(6.31±2.32 vs 7.10±2.80)and indirect bilirubin(I-Bil)(9.94±1.38 vs 10.77±1.22) before and after infusion(P>0.05).And no statistical difference was noticed in Hb (10.75±1.04 vs 10.30±0.98), TBil (3.31±1.47 vs 3.31±0.55), DBIL(2.76±1.24 vs 2.60±0.83), and I-Bil(1.97±0.40 vs 2.82±0.53) between the DTT treatment method and the DARA Fab fragment treatment before and after transfusion(P>0.05). Conclusion DARA-Fab can remove the interference of RBC on cross matching by blocking CD38 antigen. This method has no effect on the antigens of common RBC blood group systems, and shows significant blood transfusion efficacy as that of DTT method.
Authors and Affiliations
Jingdan ZHANG, Jiali SUN, Ruihui DU, Peng LI, Lida SUN, Qiang LI
Keywords
Related Articles
- EP ID EP738759
- DOI 10.13303/j.cjbt.issn.1004549x.2024.02.005
- Views 71
- Downloads 0
Identification of immune hemolytic transfusion reaction and exploration of transfusion compatibility testing
Objective To analyze the causes of immune hemolytic transfusion reaction in one case, identify related antibodies, and explore transfusion compatibility testing. Methods ABO/Rh blood group identification, unexpected anti...
Serological and molecular biological analysis of Aw43 subtype: report of two cases
Objective To conduct serological identification and molecular study of two patients with ABO ambiguous blood group. Methods The serological tests were conducted by the tube method. DNA direct sequencing was performed to...
Changes of cryoprecipitate coagulation factors prepared by different preparation methods and quick-freezing time
Objective To analyze the changes of fibrinogen (Fg) and Ⅷ factor levels of cryoprecipitated coagulation factors prepared by different methods and post-preparation quick-freezing time. Methods The fresh frozen plasma (FFP...
Autologous platelet-rich plasma treatment for infected deep second-degree burn wounds: a case report
Objective To explore the feasibility of using autologous platelet-rich plasma (PRP) in the treatment of deep second-degree burns complicated with wound infection. Methods A retrospective analysis was conducted on the tre...
Expert consensus on testing of killer-cell immunoglobulin-like receptor genes
The killer-cell immunoglobulin-like receptor(KIR) gene family exhibits complex genetic diversity. In addition to allele level polymorphisms, KIR genes show extra diversity at haplotype content as well as copy number vari...